Diabetic acidosis and diabetic ketoacidosisketoacidosis (DKA) is a complication of diabetes. If the blood sugar level of the individual is very high and insulin profoundly deficient, the body can not use glucose efficiently. Then the body starts to burn fat stores for food. How are you burning fat reserves, a by-product called ketones are released. It ketones which are responsible for reducing the pH of the body below 7.35. Metabolic acidosis occurs when the pH value of the body below 7.35. In diabetic acidosis and diabetic ketoacidosis the body tries to ketones excreted through the kidneys, which are solved to ketones in the urine, a term called ketonuria. However, together with the negative ketones, positively charged electrolytes are also excreted from the body. This leads to an imbalance in the electrolyte. The body continues to burn other stores of glucose in the body, such as proteins, resulting in nitrogen loss.
Diabetic acidosis and diabetic ketoacidosisNow the body of the electrolyte loss has. This can cause nausea and vomiting, depleting more electrolytes. The individual is now in a state of severe hyperglycemia and hypovolemic to. If these conditions are not treated, the person can succumb to hypovolemic shock, fell into a coma and die.
External signs and symptoms of CAD are the following;. Eyeballs are soft and appear sunken, skin turgor is poor, (dehydration of the tissue can be tested by pinching the fold of skin in the breastbone If the skin stays in place or do not waste your fast, then dehydration can be assumed.) Is the person very pale, cold and damp, and shows deep, rapid breathing, an attempt by the body to remove excess carbon dioxide. The person may also have severe abdominal pain and tachycardia (heart rate greater than 100 beats per minute.) Laboratory diagnosis of arterial blood gases show a pH below 7.35, the level of blood sugar over 250 mg / dl serum bicarbonate level less than 15 mmol / l, and urine ketone.
Diabetic acidosis and diabetic ketoacidosis - Interventions should be immediately to prevent irreversible destruction of the organs of the body and prevent coma or death. Ensure a clear airway and start by administering oxygen nasal cannula or mask. Make intravenous access with a large bore needle (18-20 gauge). Start liquid stabilization with 0.9 Normal Saline. This is to support an isotonic fluid to pH of the body. The purpose of using an isotonic infusion initially is to restore the blood pressure was low and increase urine cleared 30-60ml/hr. When urine less than 30 ml / h, it can quickly lead to kidney failure. Liquids should continue for an hour or until stabilization occurs. Next start insulin infusion at a rate of drip or 0.1U/kg/hr. During this time, it is important to monitor vital signs of the person every fifteen minutes until they stabilize for a few hours after the start of treatment, or at least. If, potassium are required administered to correct hypokalemia and metabolic diabetic acidosis sodium bicarbonate to correct, if the pH is below 7.0. The person must also ECG leads placed on the chest to monitor heart rate.
Preventive measures to avoid DKA are constant monitoring of blood glucose with insulin management protocol. The diabetic should avoid excessive food intake, and avoid too much or too little insulin. Stressful situations in life can also lead to increases in blood glucose levels. Therefore, the diabetic should more ready to control your blood sugar during times of stress and how to manage insulin are directed.